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SBI Arogya Plus Policy – Check Premium, Review, Renewal & Claim Process

SBI General Insurance Company offers a range of general insurance plans that help in fulfilling your insurance needs. Health insurance plans offered by the company are quite popular as they provide individuals with the necessary financial assistance in times of medical crisis. With over 6000 hospitals in its network, you can avail of cashless treatment when you buy health insurance from SBI. The company also has a robust network that includes over 22,000 branches across the length and breadth of the country.

SBI Arogya Plus – Overview

SBI Arogya Plus policy is an indemnity oriented health insurance plan which covers your actual medical expenses. The plan can be taken on an individual or a family floater basis covering your family members. The plan offers coverage for both inpatient and outpatient expenses and comes at an affordable premium.

Features of SBI Arogya Plus

Here are some of the salient features of SBI General Arogya Plus plan –

  • No pre-entrance health check-ups are needed if you are aged up to 55 years of age and you have no adverse medical conditions
  • You can avail coverage for yourself as well as your family members including your spouse, up to two dependent children, dependent parents and dependent parents-in-law
  • Expenses incurred on an outpatient basis are also covered by the policy
  • You can avail coverage for maternity-related expenses under the OPD coverage benefit of the plan
  • Attractive premium discounts are offered by the plan to reduce your premium outgo

SBI Arogya Plus – Coverage Inclusions

Here are the coverage benefits offered by SBI Arogya Plus policy –

Coverage benefit Meaning 
Inpatient hospitalisation expensesIf you are hospitalised for 24 hours or more, the expenses incurred would be covered. Such expenses would include the following –
. Room rent and boarding expenses
. Medical practitioner’s fees
. ICU charges
. Nurse’s fee
. Cost of anaesthesia, oxygen, blood, surgical appliances, etc.
. Cost of diagnostics, medicines and consumables
. Physiotherapy costs if incurred on an outpatient basis
. Surgeon’s, doctor’s and anaesthetist’s fee
Pre hospitalisation expensesThe expenses incurred before actual hospitalisation are covered under the policy for up to 60 days
Post hospitalisation expensesThe expenses incurred after being discharged from the hospital are covered for up to 90 days
Ambulance costsThe cost incurred in hiring an ambulance to transport you to the hospital would be covered up to INR 1500
Daycare treatmentsSBI General Arogya Plus plan covers 142 daycare treatments which do not require hospitalisation for 24 hours
OPD treatmentsCosts incurred on an outpatient basis, i.e. without being hospitalised, are covered under the plan. Such costs can be incurred on a doctor’s consultations and treatments
AYUSH treatmentsIf you avail treatments under non-allopathic modes like Ayurveda, Unani, Siddha and Homeopathy, such treatments would also be covered under the plan
Domiciliary treatmentsTreatments taken at your home, subject to certain terms and conditions, are covered
Maternity expensesExpenses incurred on childbirth are covered under the policy up to the limit of coverage available under the OPD coverage benefit
HIV/AIDS coverageInpatient treatments incurred due to HIV/AIDS would be covered under the plan up to a limit of INR 50,000
Mental illness coverage If you are hospitalised for the treatment of any mental or psychiatric illnesses, the cost of such treatments would be covered up to INR 50,000
Coverage for genetic disordersTreatments taken for genetic illnesses or disorders are covered up to a limit of INR 50,000
Internal congenital diseasesTreatments taken for curing internal congenital diseases would be covered up to a limit of 10% of the sum insured of the policy
Coverage for specific treatmentsSpecified treatments like balloon sinuplasty, oral chemotherapy, HIFU, robotic surgeries, etc. would be covered up to a limit of 50% of the sum insured whether taken as an inpatient or as a daycare treatment

SBI Arogya Plus – Coverage exclusions

Here is a list of some of the medical costs and treatments which are not covered under the SBI General Arogya Plus plan –

  • Pre-existing illnesses are not covered within the first 48 months of buying the policy
  • Listed illnesses and medical conditions would not be covered within the first 90 days or 12 months of buying the policy
  • Illnesses suffered within the first 30 days of buying the policy would not be covered
  • International treatments are excluded
  • Illnesses or injuries suffered due to war, nuclear perils, civil unrest, commotion and other allied perils are not covered
  • Circumcision and correction of eyesight are excluded
  • Cosmetic or plastic surgeries are not covered by the plan
  • Cost of lenses, spectacles, hearing aids, external medical equipment, etc. are excluded
  • Claims due to breach of the law, self-inflicted injuries, substance abuse, participation in hazardous activities, etc. would be excluded 
  • Unproven treatments, weight control treatments and rehabilitation expenses are not covered

Eligibility parameters of SBI Arogya Plus

Type of policyIndemnity plan
Mode of coverageIndividual or family floater
Sum insuredINR 1 lakh, INR 2 lakhs or INR 3 lakhs
Entry ageMinimum – 3 months
Maximum – 65 years
Exit ageNone. The plan offers lifelong renewals
Policy tenure1, 2 or 3 years

Claim process under SBI Arogya Plus Policy

If you suffer a medical expense which is covered under the plan, you can make a claim on your policy. You can make a cashless claim if you are hospitalised in a networked hospital. In case of a non-networked hospital, the claim would be settled on a reimbursement basis. The process of making the claim under both types of claims is as follows –

Cashless claims

  • Inform SBI General Insurance Company of your claim
  • Fill up a pre-authorization form and submit it to the TPA desk at the hospital. The form should be submitted at least 3-4 days before a planned hospitalisation. In case of an emergency, however, submit the form within 24 hours of being hospitalised
  • Based on your pre-authorization form, SBI General Insurance Company would approve your cashless claim
  • You can, then, avail cashless treatments and the insurer would settle your medical bills directly with the hospital
  • After you are discharged, fill up and submit the claim form along with the relevant medical documents to get the claim settled

Reimbursement claims

  • If you are taking treatments in a non-networked hospital, pay the medical costs that you incur.
  • After being discharged, fill up the claim form and submit it to SBI General Insurance Company along with your medical bills and relevant documents
  • The company would verify your documents and then reimburse you for the medical costs incurred

The documents required for making a claim in your SBI Arogya Plus policy include the following –

  • Filled and signed claim form
  • Proof of identity
  • Discharge summary or certificate issued by the hospital
  • All investigative and diagnostic reports
  • All medical and hospital records in original
  • Medical prescriptions and bills in original
  • Any other document as needed by the insurance company 

You can also make your health insurance claim through Turtlemint wherein you would not have to follow the above-mentioned steps. You just have to inform Turtlemint and Turtlemint’s claim team would handle your claims and get them settled at the earliest. To inform Turtlemint, call 1800 266 0101 or send a mail to support@turtlemint.com

How to buy SBI Arogya Plus policy?

To buy SBI Arogya Plus plan you can visit the official website of SBI General Insurance and buy the plan directly from the company. You can also choose to buy the plan from Turtlemint which allows you to compare different health insurance plans and then choose the best policy. To buy online through Turtlemint, here are the steps that you should take –

  • Go to https://www.turtlemint.com/health-insurance/ and choose ‘Buy new policy’
  • Enter in the following details –
    • Gender 
    • Members to be covered
    • Age of each member
    • Whether or not you are planning a child
    • Does any member suffer from any existing illness?
    • PIN Code
  • You can, then, locate the nearest hospitals in your area
  • Provide your contact details for personalised assistance in buying the best plan
  • When you submit these details, Turtlemint would show you the plans and quotes of leading health insurance companies
  • Compare the available plans and then select the best policy that you need

Documents required for buying SBI Arogya Plus

To buy SBI General Arogya Plus plan, the following documents would be needed –

  • A valid proof of identity
  • A valid proof of age
  • A valid proof of address
  • Proposal form, filled and signed
  • Latest coloured photographs of the members to be insured
  • Medical reports if pre-entrance health check-ups are needed

How to renew SBI Arogya Plus policy?

SBI Arogya Plus offers lifelong coverage if you renew your plan regularly. Renewal of the policy can be done online from the company’s website. You can visit https://www.sbigeneral.in/portal/policy-renewal, select your health insurance policy and enter your policy number to check the existing policy. The renewal premium would be calculated using the SBI Arogya Plus premium calculator available online.

You can also increase the sum insured on renewal and/or add or delete family members. Any change done during renewal would change the renewal premium and the SBI Arogya Plus premium calculator would show the updated renewal premium. Pay the premium online and your policy would be renewed instantly.

If you have bought the policy through Turtlemint you can renew the plan online through Turtlemint’s platform itself. Just log into your online Turtlemint account, select the policy, pay the renewal premium and renew the plan instantly.

SBI Arogya Plus premium calculator

SBI Arogya Plus premium calculator is an online tool which allows you to calculate the premium payable for the policy. You need to visit https://www.sbigeneral.in/portal/buy-online/healthinsurancePlus/display_page?itm_source=direct&itm_medium=none&itm_campaign= and enter the following details to find the premium –

  • Your gender
  • Family members to be insured
  • Date of birth of the members to be insured
  • Type of plan – floater or individual
  • Your name, mobile number and email ID

An OTP would be sent to your mobile number and after you verify it, the SBI Arogya Plus premium calculator would calculate and show the premium payable.

You can also use Turtlemint’s premium calculator to find out the premium payable for SBI Arogya Plus policy.

SBI Arogya Plus premium chart

The SBI Arogya Plus premium chart is also available using which you can check the premium payable for the policy. You can find the SBI Arogya Plus premium chart on the policy brochure as well in the prospectus offered by the company.

SBI Arogya Plus Review

If you are looking for a simple health plan with affordable premiums and inclusive coverage, SBI Arogya Plus policy is a good choice. SBI Arogya Plus review shows that the policy allows coverage for HIV/AIDS, mental illnesses, congenital illnesses and advanced robotic surgeries which make the coverage unique. The sum insured is low to allow you affordable coverage.

So, buy SBI Arogya Plus for basic health insurance coverage either for yourself or your whole family and get protection against expensive medical costs.

FAQ’s

There are different types of premium discounts available with the plan. These discounts are as follows –

  • If two members are covered – 5% discount
  • If more than two members are covered – 7.5% discount
  • If a term of 2 years is selected – 5% discount
  • If a term of 3 years is selected – 7.5% discount
  • If you buy the policy online from SBI’s website – 15% discount

No, no claim bonus is not offered by the plan.

No, enhancement of the sum insured would not be allowed during the coverage duration. You can enhance the sum insured only at the time of renewals.

SBI Arogya Plus offers a grace period of 30 days beyond the renewal date. During this grace period, if you renew the policy, you would get continuity benefits of reduction in the waiting periods. However, coverage would not be allowed during the grace period.

No, instalment premiums are not allowed under the policy. You would have to pay the premium in one lump sum when buying or renewing the plan.

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